Effect of therapeutic regimens and polypharmacy on health-related quality of life of people with multiple myeloma: a cross-sectional study in Belo Horizonte, Brazil

Abstract

Objective

Multiple myeloma (MM) is an incurable hematological cancer and its treatment is geared to promote better Health-Related Quality of Life (HRQoL). We aimed to assess HRQoL and compare scores between variables on therapeutic regimens and polypharmacy in MM patients.

Methods

This cross-sectional study was performed from April/2019 to February/2020 in Belo Horizonte, Brazil. HRQoL scores were obtained by the QLQ-C30 and QLQ-MY20 instruments. Data were retrieved from interviews and medical records. Therapeutic regimens were grouped into thalidomide-containing regimens; bortezomib-containing regimens; bortezomib and thalidomide-containing regimens; other therapeutic regimens, and remission group. We performed univariate analyses by the Mann-Whitney method and adopted the Kruskal-Wallis test for multiple comparisons. Robust multiple linear regression was used to determine the association between independent variables and the HRQoL scores.

Results

The sample included 225 participants and most patients (65.3%) were on active treatment and had worse scores concerning future perspective. Polypharmacy was associated with worse scores on all scales in the univariate analyses. We observed a difference in the global health and body image (p < .05) scales in the multiple comparisons with therapeutic regimens. The global health scale difference was found between groups with other regimens and the remission group (p < .05). The difference between the bortezomib and thalidomide-containing regimens and remission group was not statistically significant (p = .077) in the body image scale. The multiple linear regression maintained the association of polypharmacy with worse HRQoL scores.

Conclusion

We identified an independent association between HRQoL and polypharmacy in MM patients. However, there was no difference between the evaluated regimens, suggesting they are equivalent in Brazil about HRQoL.

Keywords:

• Health-related quality of life
• multiple myeloma
• therapeutic regimens
• polypharmacy

Transparency

Declaration of funding

This paper was not funded

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

J.S.M., C.A.M.P., L.P.S., P.L.M.D., A.M.M.R. and R.M.M.S. Santos contributed substantially to the conception and design of the work. J.S.M., L.P.S., P.L.M.D. and N.L.C. contributed substantially to the data collection. J.S.M., C.A.M.P., C.J.M. and A.M.M.R. performed the analysis and interpretation of data. All the authors contributed substantially to the draft of the manuscript. The final version of the manuscript was approved by all the authors.

Acknowledgements

To CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) for the scholarship for the master’s degree of the first author. To the hospitals of the public health system and to the “Clínica Hematológica”, private clinic, for their availability to be the participating centers for carrying out the study.

Data  availability statement

Research data are not shared. The data are not publicly available due to privacy or ethical restrictions.

Ethics approval

The questionnaire and methodology for this study were approved by the Human Research Ethics committee of the Federal University of Minas Gerais (Ethics approval number: CAAE-05400818.3.0000.5149 and 05400818.3.3004.5119).